"It’s a good thing you came for an examination, or you might have fainted and been taken to the hospital next week."
Three years ago, 28-year-old Shi Mairu (pseudonym) was told by a doctor that she had ketoacidosis during a routine physical examination. After a series of tests, she was finally diagnosed with diabetes. Before that, she was unaware of her physical problems.
Diabetic ketoacidosis is the most common diabetic emergency. In 2021, "Mocha Official", a blogger in online celebrity, bilibili, was found to be suffering from diabetes when removing a tumor, and finally died of ketoacidosis, which made people feel sad.
Chen Hongjie, who works in the trading industry, is 34 years old. He went to the hospital for an examination six months ago. By mistake, he took a blood sugar concentration test, and the result showed insulin resistance. Insulin resistance is one of the pathogenic factors of type II diabetes. But fortunately for Shi Mairu, it is hopeful to achieve clinical reversal and return to normal level because it is found earlier and controlled in the stage of insulin resistance.
In recent years, there are not a few young people like Shi Mairu and Chen Hongjie who suddenly suffer from diabetes. The Report on Nutrition and Chronic Diseases of Residents in China (2020) shows that the prevalence rate of diabetes among residents aged 18 and above in China is 11.9%, and the detection rate of pre-diabetes is 35.2%, among which type II diabetes is the main type. Diabetes has the characteristics of younger age, long course of disease and many complications.
Diabetes mellitus is a series of metabolic disorder syndromes of sugar, protein, fat, water and electrolyte caused by various pathogenic factors such as genetic factors and endocrine dysfunction, which leads to islet dysfunction and insulin resistance. Clinically, hyperglycemia is the main feature, and the typical symptoms are three more and one less (drinking more, eating more, urinating more and losing weight).
Long-term chronic hyperglycemia can cause damage to tissues and organs such as eyes, nerves, kidneys and cardiovascular system, and then a series of complications occur. Because of the large number of patients and serious harm to human health, diabetes has become an important public health problem in China.
Diabetes is mostly related to unreasonable diet.
Recently, the "Guidelines on Diet and Nutrition for Adults with Diabetes (2023 Edition)" (hereinafter referred to as the "Guidelines") issued by official website, National Health Commission shows that the risk factors of diabetes are mostly related to unreasonable diet, including long-term high-sugar, high-fat and high-energy diets.
Indeed, before the diagnosis, both Shi Mairu and Chen Hongjie lived very unhealthy lives.
In diet, Shi Mairu likes to eat foods with high oil and sugar, spicy, sweet and greasy taste. Because of work, she has little time to exercise, and it is common to stay up late and have irregular work and rest. "I used to drink sugar-free milk tea and sugar-free drinks with luck, thinking that this would not affect my health. Now that I think about it, I am deceiving myself. "
Chen Hongjie used to play games with friends until late at night, and it was inevitable that he would have a beer barbecue after the end. "I know that this lifestyle is unhealthy, but I always feel that I will not have an accident when I am young. Now I really regret it."
In view of the daily diet of diabetic patients, the Guide puts forward eight principles and suggestions, including: 1. Diversified foods, developing and establishing reasonable dietary habits; Second, appropriate energy, control overweight and obesity and prevent emaciation; 3. Quantify staple foods, preferably whole grains and foods with low glycemic index; Fourth, actively exercise to improve physical fitness and insulin sensitivity; Five, light diet, limit drinking, prevent and delay complications; Sixth, there is a proper way to eat and raise food, and reasonable selection and application of edible and medicinal substances; Seven, regular meals, reasonable meals, and promote the stability of blood sugar after meals; Eight, self-management, regular nutrition consultation, improve blood sugar control ability.
The Guide emphasizes that correcting unhealthy lifestyle, practicing reasonable diet and active exercise are effective means to prevent and control the occurrence and development of diabetes, which can help patients control their blood sugar well, prevent and delay the occurrence of diabetic complications, improve their quality of life and save medical expenses.
Dietary management is the core of controlling blood sugar.
Dietary management and treatment are the core of blood sugar control in diabetic patients. The Guide suggests that diabetic patients should follow the principle of balanced diet.
It is mentioned in the Guide that food diversity is the basis for achieving a reasonable diet and balanced nutrition. The diet of diabetic patients should include five categories of food: sweet potatoes, vegetables and fruits, animal food, soybeans and nuts, cooking oil and salt. The recommended ratio of macronutrients to total energy of diabetic patients is 15%-20% in protein, 45%-60% in carbohydrate and 20%-35% in fat. On the basis of keeping food diverse, we should reduce oil, salt, sugar and wine.
The staple food is rich in carbohydrates, which is the core factor affecting the postprandial blood sugar level. The Guide suggests that diabetic patients should not eat too much staple food, and choose more whole grains and low GI foods, among which low GI foods such as whole grains and miscellaneous beans should account for more than 1/3 of the staple food. In addition, we should develop the habit of eating vegetables first and staple food last in order to control blood sugar.
At the same time, diabetics should cultivate a light taste. The daily consumption of cooking oil should be controlled within 25 grams, and the daily consumption of salt should not exceed 5 grams. Pay attention to limiting the intake of condiments and foods with high salt content such as soy sauce, chicken essence, monosodium glutamate, pickles, bacon and pickles.
People with different syndrome types and different regions can "eat according to syndrome differentiation"
In addition to the daily dietary advice, the Guide also mentions the principle of Chinese medicine’s food support with "dialectical diet" as the core. For diabetic patients with different constitutions, selecting foods or medicinal substances with different characteristics can effectively improve the blood sugar level of patients.
Traditional Chinese medicine divides diabetes into three categories: first, excessive heat due to yin deficiency, manifested as polydipsia and polydipsia, dry throat and tongue, overeating and hunger, dark red constipation, red tongue with little body fluid and yellow fur, and slippery or thready pulse; Second, deficiency of both qi and yin, manifested as fatigue, palpitation, shortness of breath, night sweats, spontaneous sweating, dry mouth, excessive drinking and urination, vexation and heat, constipation, soreness of waist and knees, pale or dark tongue, teeth marks on the edge of tongue, thin and white fur, or less fur, and weak pulse; Third, deficiency of both yin and yang, manifested as fatigue and spontaneous sweating, cold limbs, soreness in waist and knees, dry helix, excessive drinking and diuresis, edema and oliguria, or diarrhea due to five shifts, impotence and premature ejaculation, pale tongue with white fur, and deep and thin pulse.
According to the principle of syndrome differentiation and treatment of traditional Chinese medicine, the daily diet is combined with traditional Chinese medicine health-preserving recipes. Due to yin deficiency and heat excess, medicinal materials with the functions of nourishing yin and clearing away heat are used, such as mulberry leaves, cassia seeds and lotus seeds. The syndrome of deficiency of both qi and yin adopts edible medicinal substances with the functions of benefiting qi and nourishing yin, such as mulberry, medlar, kudzu root, etc. Chinese yam, poria cocos and cinnamon can be used for deficiency of yin and yang.
The Guide also refers to the dietary practices in different regions, and recommends all-day dietary recipes suitable for diabetic patients in different regions and seasons according to the food resources and dietary characteristics of people in different regions.
For example, in North China where Shi Mairu lives, he likes pasta, livestock and poultry, and vegetables and aquatic products are not consumed much. The recipe follows the principle of food support for diabetic patients, and it is suggested to increase the intake of vegetables and aquatic products, and emphasize the choice of seasonal food according to the characteristics of four distinct seasons.
In South China, where Chen Hongjie is located, the dietary characteristics are mainly Cantonese cuisine culture, and the most obvious feature is that "you can’t eat without soup", and the soup often uses edible and medicinal substances; Secondly, South China is rich in rice, which mainly feeds on rice, such as rice rolls, rice noodles, radish cakes, rice cakes and other exquisite cakes. The recipe follows the principle of food support for diabetic patients, and suggests that patients should have a quantitative staple food, and at the same time, reasonably match the seasonal characteristic ingredients in South China.
It is never too late to live a healthy life.
The Guide also suggests that diabetic patients record their diet, exercise and blood sugar levels, so as to improve the scientific planning level of blood sugar control and self-management.
At the suggestion of the doctor, Shi Mairu created a staple food sugar record table, which recorded the staple food she ate and the sugar she ingested at each meal. "Before eating, I will take out the record form to see if there is any excess today. If it is excessive, then restrain it; If not, just eat a little. "
When she was first diagnosed, Shi Mairu went through a period of collapse. During that time, she almost didn’t eat staple food and didn’t dare to eat any food with high oil and sugar in order to control sugar, but suddenly giving up sugar made her feel very tormented and it was difficult to stick to it. "With the record sheet, I began to plan my diet reasonably, not as extreme as before, which made it easier for me to stick to it."
The Guide also suggests that diabetics should exercise after meals for at least 5 days a week for 30-45 minutes each time, and moderate-intensity exercise should account for more than 50%, step by step and persistently.
For young people, diabetes brings more psychological stress than physical pain. In the communication with patients, Shi Mairu found that everyone was generally worried that diabetes would affect future development and marriage and childbirth. And Chen Hongjie often jumped repeatedly between "forced to accept" and "unbelievable" a few months ago. "Although I still have a chance to achieve a reversal, I feel like a damaged wheel. I need to pay attention to the control of blood sugar for the rest of my life so that the wheel will not be damaged."
"However, healthy living is not as difficult as imagined." Encouraged by his girlfriend, Chen Hongjie began to change the rules of life, eat a reasonable and nutritious diet, go to bed early and get up early, and seize all the interval exercises. "Health is a kind of accumulation. If you can stay up late less, you will stay up less. If you can drink less milk tea, you will drink less milk tea. If you can exercise more, you will exercise more, even if it is only 10 minutes!" Now, Chen Hongjie’s blood sugar has been basically controlled.
"Most people don’t know that diabetes will have an incubation period of 2-3 years. Early detection and correction at this stage can be completely reversed." Chen Hongjie said, "Many young people like me know very little about diabetes, and always feel that it is a very distant thing from us to have diabetes. I want to use my own experience to appeal to young people to pay attention to blood sugar and diabetes. "
Chen Hongjie said, "You only need to pay more attention, learn more about the knowledge of preventing diabetes, regulate your behavior under the premise of attention, and try to maintain yourself in a healthy state, which will greatly avoid the occurrence of diabetes."
The best time to plant a tree is 10 years ago, followed by now. The same is true for everyone’s healthy life.
Zhongqingbao Zhongqingwang Trainee Reporter Si Tan
